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National Association for Home Care & Hospice
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In the various roles he has undertaken through the years, Val J. Halamandaris has been a singular driving force behind the policy and program initiatives resulting in the recognition of home health care as a viable alternative to institutionalization. His dedication to consumer advocacy, which enhances the quality of life and dignity of those receiving home health care, merits VNA HealthCare Group’s highest recognition and deepest respect. 

VNA HealthCare Group

I have the highest respect for them, especially for the nurses, aides and therapists, who devote their lives to caring for people with disabilities, the infirm and dying Americans.  There are few more noble professions.

President Barack Obama

Home health care agencies do such a wonderful job in this country helping people to be able to remain at home and allowing them to receive services

U.S. Senator Debbie Stabenow (D-MI) Chair, Democratic Steering and Outreach Committee

Home care is a combination of compassion and efficiency.  It is less expensive than institutional care...but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human’s a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals or other institutions

Former Speaker of the U.S. House of Representatives Newt Gingrich (R-GA)

Medicaid covers long-term care, but only for low-income families.  And Medicare only pays for care that is connected to a hospital discharge....our health care system must cover these vital services...[and] we should promote home-based care, which most people prefer, instead of the institutional care that we emphasize now.

Former U.S. Senator Majority Leader Tom Daschle (D-CD)

We need incentives to...keep people in home health care settings...It’s dramatically less expensive than long term care.

U.S. Senator John McCain (R-AZ)


Home care is clearly the wave of the future. It’s clearly where patients want to be cared for. I come from an ethnic family and when a member of our family is severely ill, we would never consider taking them to get institutional care. That’s true of many families for both cultural and financial reasons. If patients have a choice of where they want to be cared for, where it’s done the right way, they choose home.

Donna Shalala, former Secretary of Health and Human Services

A couple of years ago, I spent a little bit of time with the National Association for Home Care & Hospice and its president, Val J. Halamandaris, and I was just blown away. What impressed me so much was that they talked about what they do as opposed to just the strategies of how to deal with Washington or Sacramento or Albany or whatever the case may be. Val is a fanatic about care, and it comes through in every way known to mankind. It comes through in the speakers he invites to their events; it comes through in all the stuff he shares.

Tom Peters, author of In Search of Excellence

Val’s home care organization brings thousands of caregivers together into a dynamic organization that provides them with valuable resources and tools to be even better in their important work. He helps them build self-esteem, which leads to self-motivation.

Mike Vance, former Dean of Disney and author of Think Out of the Box

Val is one of the greatest advocates for seniors in America. He goes beyond the call of duty every time.

Arthur S. Flemming, former Secretary of Health, Education, and Welfare

Val has brought the problems, the challenges, and the opportunities out in the open for everyone to look at. He is a visionary pointing the direction for us. 

Margaret (Peg) Cushman, Professor of Nursing and former President of the Visiting Nurses Association

Although Val has chosen to stay in the background, he deserves much of the credit for what was accomplished both at the U.S. Senate Special Committee on Aging, where he was closely associated with me and at the House Select Committee on Aging, where he was Congressman Claude Pepper’s senior counsel and closest advisor. He put together more hearings on the subject of aging, wrote more reports, drafted more bills, and had more influence on the direction of events than anyone before him or since.

Frank E. Moss, former U.S. Senator

Val’s most important contribution is pulling together all elements of home health care and being able to organize and energize the people involved in the industry.

Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

Kathleen Gardner Cravedi, former Staff Director of the House Select Committee on Aging

Without your untiring support and active participation, the voices of people advocating meaningful and compassionate health care reform may not have been heard by national leaders.

Michael Sullivan, Former Executive Director, Indiana Association for Home Care

All of us have been members of many organizations and NAHC is simply the best there is. NAHC aspires to excellence in every respect; its staff has been repeatedly honored as the best in Washington; the organization lives by the highest values and has demonstrated a passionate interest in the well-being of patients and providers.

Elaine Stephens, Director of Home Care of Steward Home Care/Steward Health Systems and former NAHC C

Home care increasingly is one of the basic building blocks in the developing system of long-term care.  On both economic and recuperative bases, home health care will continue to grow as an essential service for individuals, for families and for the community as a whole.

Former U.S. Senator Olympia Snowe (R-ME)

NCOA is excited to be part of this great event and honored to have such influential award winners in the field of aging.

National Council of Aging

Health care at home…is something we need more of, not less of.  Let us make a commitment to preventive and long-term care.  Let us encourage home care as an alternative to nursing homes and give folks a little help to have their parents there.

Former President Bill Clinton

Bipartisan, Bicameral Effort Underway to Advance Medicare Post-Acute Reform

House Ways and Means and Senate Finance Committees Release Draft Legislation to reform post-acute care; NAHC submitted proposals to the Committees last summer offering the home health and hospice perspective
March 22, 2014 10:34 AM

Ways and Means Committee Chairman Dave Camp (R-MI) and Ranking Member Sandy Levin (D-MI) along with Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Orrin Hatch (R-UT) released a discussion draft titled, Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act of 2014).  The IMPACT Act of 2014 aims to update Medicare payments to post-acute care (PAC) providers by focusing on more accountable care, and moving towards more of a quality-driven PAC benefit.  The draft legislation is intended to serve as the core building block for future Medicare PAC reforms between the House and Senate Committees that have jurisdiction over Medicare policy.

Last year, Committee leaders invited interested stakeholders to submit ideas on how to strengthen post-acute care (PAC), a variety of health care services that support a patient's continued recovery from a serious illness.  Post-acute care includes services in Long Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), Skilled Nursing Facilities (SNFs), and Home Health Agencies (HHAs). The resounding theme from the more than 70 letters received was the need for standardized post-acute assessment data across Medicare PAC provider settings. NAHC submitted extensive comments and recommendations on post-acute care reforms.

For more on the comments NAHC submitted to the committees on how to reform to post-acute care, please see NAHC ReportSeptember 4, 2013.

The IMPACT Act of 2014 is based on the policy and legislative recommendations of more than 70 stakeholders in the health care community and will help lay the groundwork for the modernization of PAC services within Medicare to ensure the program works better for beneficiaries and taxpayers alike.

Without comparable information across PAC settings, policymakers and providers cannot determine whether patients treated and the care provided in different settings is, in fact, the same or whether one PAC setting is more appropriate. Absent this information, it is difficult to move forward with PAC payment reforms.

The IMPACT Act of 2014 requires standardized data that will enable Medicare to:

  • Compare quality across PAC settings;
  • Improve hospital and PAC discharge planning; and,
  • Use this information to reform PAC payments (via site neutral or bundled payments or some other reform) while ensuring continued beneficiary access to the most appropriate setting of care.

This bill can inform changes that the lawmakers believe will better enable Medicare patients to receive the right high-quality, post-acute care in the right setting at the right time.  

Following the release of the discussion draft, the Committee leaders will work with their colleagues and experts within the health care community to further improve the legislative draft, with the goal of formally introducing consensus legislation in the future.

NAHC attended a briefing on the proposal on March 20. The staff from the Senate Finance Committee and the House Ways & Means Committee emphasized that payment and service reforms in post-acute care require a solid foundation in valid data. They view the proposal as a means to create that foundational database with the development of a uniform PAC patient assessment instrument, the establishment of quality of care measures, and the integration of the tools with hospital discharge planning.

At the end of these data development efforts is an analysis of potential payment reforms by CMS and MedPAC. Potential reforms include PAC bundling, a PAC prospective payment system, and site-neutral payments. However, congressional staff expressed that such reforms are likely at some extended time in the future. The timeline that was discussed had a MedPAC report to Congress on payment reforms due in 2022.

Overall, NAHC is supportive of developing a uniform patient assessment instrument for post-acute care. It is hoped that the development of such tool will build on experiences with OASIS and the CARE tool that was piloted recently. As constructed, the congressional proposal aims to transition PAC providers slowly to any new assessment processes, doing so in a way that avoids undue burdens. That may be easier said than done.

In the briefing, NAHC recommended that the proposal be revised to add a requirement that CMS develop the reforms through engagement and consultation with all PAC stakeholders.    
A summary of the discussion draft can be found here.

A more detailed section-by-section review can be found here.




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